A hernia is the formation of an opening in the abdominal wall typically accompanied with abdominal tissue and viscera which pushes through the opening in the abdominal wall. The abdominal wall has several relatively weak regions where hernias tend to occur with greatest frequency. These include the inguinal canal and the femoral ring.
The treatment of a hernia in a patient's abdominal wall frequently involves surgery in an effort to repair the defect. The abdominal tissue that has pushed through the defect in the abdominal wall includes a sack lined by the peritoneum with viscera contained in the sack. Treatment requires that the contents of the sack be returned to a normal position in the abdomen or, if that cannot be done, the protruding sack and viscera must be removed surgically. The defect in the abdominal wall then is surgically repaired by suturing the ruptured muscle in an effort to close the defect and restore the integrity of the abdominal wall.
Conventional procedures for hernia repair frequently provide only temporary relief. Typically, they involve stretching of the musculature and ligamentous tissue in order to close the defect. The tissues are sutured while in a stretched configuration which makes the abdominal wall further susceptible to a recurring hernia. Surgical correction of a recurring hernia typically results in further degeneration of the involved muscles and ligaments.
In an effort to avoid recurring hernias and the resulting progressive deterioration surgeons commonly use sheets of implantable mesh material, such as a knitted polypropylene fabric available under the designation Marlex mesh. The sheet of polypropylene mesh material is placed over the defect and may be sutured in place as determined by the surgeon. Although some hernias may be treated in that manner with some success, many ultimately result in failure and recurrence of the hernia.
After a number of surgical treatments for recurring inguinal hernias, a patient's inguinal ligament often deteriorates to a point of total or near total destruction. Often the results of such recurrent hernia is that the floor of the inguinal canal and iliopubic tract also are totally destroyed or severely deteriorated so that there is no site to which the abdominal muscles can be reattached. There has been no effective treatment for such patients and they often must wear an external appliance, or truss, to hold in the viscera and bowels.
It is among the objects of the present invention to provide a novel prosthetic device which facilitates surgical repair and reconstruction of an otherwise unrepairable inguinal hernia and by a technique which relieves the problem with very substantially reduced risk of reoccurrence.
Another commonly encountered type of hernia is the femoral hernia, which forms in the femoral ring in the iliopubic tract spanning the gap between the inguinal ligament and the pubic bone. Surgical repair of a femoral hernia typically has involved extensive surgery in which the patient is under general anesthesia. The femoral hernia normally is repaired by stretching the herniated, relatively thin lacunar ligament to close the defect. That procedure also tends to stretch and, therefore, weaken the involved region and enhances the chance of recurrence. It also is among the general objects of the invention to provide a new prosthesis and surgical technique for repair of femoral hernias which may be performed quickly and, in some cases, under local anesthesia while minimizing the chance of recurrence.